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Martha Coakley and 'Sidecar' Reconciliation: The Public Option Lives Again

While Howard Fineman is reporting that Congressional “groupthink” just wants health care to go away,
as Weiner says, the reality should be closer to Robinson’s
predictions. The Democrats can’t just walk away from the signature
issue they’ve devoted so much energy to, nor can they pass a giant
giveaway to the insurance companies and PhRMA without huge electoral
consequences.

So what option do they have to fix the health care bill that doesn’t require 60 votes in the Senate?

Well, Chris Van Hollen is now using the “R” word
— reconciliation. It’s interesting that the head of the DCCC, whose
job it is to get Democrats elected in 2010, is the one who recognizes
the need to rescue the health care bill from the Senate corporatists
like Joe Lieberman who would take the entire party down to give Aetna a
big payday. Win-win for him, really.

Passing the Senate bill first, and then
fixing it with reconciliation, could also create strong political and
policy pressure for reviving the public option or Medicare buy-in.
Probably the only way they could jam the Senate bill “as is” through
the House would be to get labor on board. To get labor, you need to
promise to fix the excise tax, and probably the only way to do that is
by using reconciliation. The unions agreed to a “fix” of the excise tax
that would cost $60 billion.
That money needs to be recouped through other tax increases or
cost-cutting measures. Even a weak, “level playing field” public option
would save $25 billion, and increasing Medicaid from 133% to 150% FPL
should save another several billion.

The steps to get through “sidecar” reconciliation:

House passes the Senate bill

House and Senate pass a “fix” to the excise tax that they’ve negotiated

Find a way to pay for the “fix,” which costs $60 billion. The best
way to pay for it without raising taxes means putting in a public
option, expanding Medicare, passing Dorgan’s drug reimportation
amendment, or some combination of the above.

The alternative to paying for the excise tax “fix” with any of these is to raise taxes. Let’s see them try and sell that.

Why would anyone trust that Congress would make this fix after passing the Senate bill?

The adminisration has made such a big deal about how their “fix” of
the excise tax helps the middle class, they’d suffer even MORE damage
if they reneged. And the unions would — quite rightly — go apeshit (or
face a rebellion within their own ranks) if they didn’t.

Even Republicans like John Shadegg
have been running around saying the public option is a superior outcome
to the current bill, which simply forces people to buy insurance from
the companies who created this problem in the first place. As we’ve
seen in polling in both Vic Snyder and Steve Driehaus’s districts, that’s a wildly unpopular concept.

How long would “sidecar” reconciliation take?

Theoretically, it could happen quickly in the Senate, since the
underlying bill has already passed. The Finance and HELP committees
would probably have to approve, and then it could go to the floor for a
vote.

None of this, by the way, is a function of what happens to day in
Massachusetts. It can — and should – happen regardless of what happens
with the Coakley/Brown election in Massachusetts today. The Democrats
have a huge perception problem that the health care bill is just the
bank bailout extended to the insurance companies, and they need to fix
it if they want to turn the ship around before the 2010 elections.

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Further

To those who consider Trump a reptilian shape-shifter, mazel tov: Now he officially is one. Thanks to a species-naming auction for Rainforest Trust, a small, blind, worm-like, newly discovered amphibian who buries its head in the ground will be named Dermophis donaldtrumpi. The name, says its creator, is "perfect" for the new caecilian, from the Latin for "blind...perfectly mirroring the strategic vision (Trump) has consistently shown towards climate change.”

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